Shingles

Definition

Shingles is a painful infection of the nerves and skin.

Causes

Shingles is caused by the
varicella zoster virus. This is the same virus that causes
chickenpox.
Shingles occurs in people who have had chickenpox in their lifetime. After causing the first chickenpox infection, the virus is not totally eliminated from the body. Some of the remaining virus settles in nerve roots near the spinal cord. When reactivated, the virus travels along nerve paths to the skin where it causes pain and a rash.

Shingles is not usually transmitted from one person to another, but a person who has never had chickenpox and never received the
varicella
vaccine
is likely to get chickenpox if contact occurs with a person who has shingles.
Covering shingles sores with a bandage reduces the risk of transmitting shingles to others.

Symptoms

Shingles may cause:

Rash:

Red and has a slightly raised band or patch, often with multiple small fluid-filled blisters that dry out and crust within several days

Develops on one side of the body, but typically does not cross the midline

Affects mostly the torso and face

The eyes to be affected, in severe cases, which can threaten vision

Sensitivity and pain on the skin at the site of the rash; pain may be severe

Tingling or itchiness on the skin, which may start a few days before the rash

Fever

Headache

Tiredness

The rash usually disappears within 3 weeks. In some cases, though, post-herpetic neuralgia (PHN) develops. With PHN, the pain continues for months or even years after the rash has healed. PHN can be severe and difficult to treat.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. The rash can be diagnosed by its appearance. Fluids may be drawn from the blisters for testing, but this is not done often.

Treatment

Shingles cannot be cured. Treatment focuses on:

Easing symptoms

Speeding recovery

Preventing PHN

Home Remedies and Over-the-Counter Products

The following will help relieve pain and ease symptoms:

Calamine lotion

Wet compresses

Frequent oatmeal baths

Over-the-counter pain relievers

Topical pain relievers that are applied to the skin

Antiviral Medication

Antiviral medications may control shingles. Antiviral therapy may shorten a shingles episode, but you must start it within 48-72 hours after symptoms first develop. They are especially used in people with suppressed immune systems.

Treatment for Shingles of the Eye

If you develop shingles on your face, contact your doctor right away. You may be prescribed medications, such as steroids, to treat this condition. Without treatment, permanent eye damage can result, including glaucoma, scarring, and blindness.

Prevention

The
herpes zoster vaccine is advised for people aged 60 years and older. The vaccine decreases the likelihood of getting shingles and reduces the severity of PHN if shingles does occur.

If you do have shingles, take these steps to prevent giving chickenpox to others:

Keep all blisters covered with a bandage until they are dry and crusted over.

If you are a healthcare worker, do not return to work until the blisters are dry and crusted over.

Avoid contact with people who are at risk of getting severe varicella, such as:

Pregnant women

Premature infants

People who have a compromised immune system

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Shingles. American Academy of Family Physicians Family Doctor website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/shingles.html. Updated April 2014. Accessed February 9, 2016.